Health system redesign for maternal and newborn survival: rethinking care models to close the global equity gap
Large disparities in maternal and neonatal mortality exist between low- and high-income countries. Mothers and babies continue to die at high rates in many countries despite substantial increases in facility birth. One reason for this may be the current design of health systems in most low-income co...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-10-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/5/10/e002539.full |
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| author | Ana Langer Sanam Roder-DeWan Kojo Nimako Nana A Y Twum-Danso Archana Amatya Margaret Kruk |
| author_facet | Ana Langer Sanam Roder-DeWan Kojo Nimako Nana A Y Twum-Danso Archana Amatya Margaret Kruk |
| author_sort | Ana Langer |
| collection | DOAJ |
| description | Large disparities in maternal and neonatal mortality exist between low- and high-income countries. Mothers and babies continue to die at high rates in many countries despite substantial increases in facility birth. One reason for this may be the current design of health systems in most low-income countries where, unlike in high-income countries, a substantial proportion of births occur in primary care facilities that cannot offer definitive care for complications. We argue that the current inequity in care for childbirth is a global double standard that limits progress on maternal and newborn survival. We propose that health systems need to be redesigned to shift all deliveries to hospitals or other advanced care facilities to bring care in line with global best practice. Health system redesign will require investing in high-quality hospitals with excellent midwifery and obstetric care, boosting quality of primary care clinics for antenatal, postnatal, and newborn care, decreasing access and financial barriers, and mobilizing populations to demand high-quality care. Redesign is a structural reform that is contingent on political leadership that envisions a health system designed to deliver high-quality, respectful care to all women giving birth. Getting redesign right will require focused investments, local design and adaptation, and robust evaluation. |
| format | Article |
| id | doaj-art-07ec1fe17ea542d4b4e45765a1b2e598 |
| institution | OA Journals |
| issn | 2059-7908 |
| language | English |
| publishDate | 2020-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-07ec1fe17ea542d4b4e45765a1b2e5982025-08-20T02:33:42ZengBMJ Publishing GroupBMJ Global Health2059-79082020-10-0151010.1136/bmjgh-2020-002539Health system redesign for maternal and newborn survival: rethinking care models to close the global equity gapAna Langer0Sanam Roder-DeWan1Kojo Nimako2Nana A Y Twum-Danso3Archana Amatya4Margaret Kruk5Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USADepartment of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, USAsenior health specialistMaternal and Child Health, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USAHealth and Nutrition, Save the Children, Kathmandu, Nepal2 Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USALarge disparities in maternal and neonatal mortality exist between low- and high-income countries. Mothers and babies continue to die at high rates in many countries despite substantial increases in facility birth. One reason for this may be the current design of health systems in most low-income countries where, unlike in high-income countries, a substantial proportion of births occur in primary care facilities that cannot offer definitive care for complications. We argue that the current inequity in care for childbirth is a global double standard that limits progress on maternal and newborn survival. We propose that health systems need to be redesigned to shift all deliveries to hospitals or other advanced care facilities to bring care in line with global best practice. Health system redesign will require investing in high-quality hospitals with excellent midwifery and obstetric care, boosting quality of primary care clinics for antenatal, postnatal, and newborn care, decreasing access and financial barriers, and mobilizing populations to demand high-quality care. Redesign is a structural reform that is contingent on political leadership that envisions a health system designed to deliver high-quality, respectful care to all women giving birth. Getting redesign right will require focused investments, local design and adaptation, and robust evaluation.https://gh.bmj.com/content/5/10/e002539.full |
| spellingShingle | Ana Langer Sanam Roder-DeWan Kojo Nimako Nana A Y Twum-Danso Archana Amatya Margaret Kruk Health system redesign for maternal and newborn survival: rethinking care models to close the global equity gap BMJ Global Health |
| title | Health system redesign for maternal and newborn survival: rethinking care models to close the global equity gap |
| title_full | Health system redesign for maternal and newborn survival: rethinking care models to close the global equity gap |
| title_fullStr | Health system redesign for maternal and newborn survival: rethinking care models to close the global equity gap |
| title_full_unstemmed | Health system redesign for maternal and newborn survival: rethinking care models to close the global equity gap |
| title_short | Health system redesign for maternal and newborn survival: rethinking care models to close the global equity gap |
| title_sort | health system redesign for maternal and newborn survival rethinking care models to close the global equity gap |
| url | https://gh.bmj.com/content/5/10/e002539.full |
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